Urology

Outpatients

Central Outpatient appointment line: 01782 676676

War​ds

Ward 106 - Urology

Ward 106 - Urology 

Ward 104- Surgical Assessment Unit 01782 671411

Ward 105 - Day Surgery and Admissions Unit - Female: 01782 672950

Ward 105 - Day Surgery and Admissions Unit - Male: 01782 672960

Sta​​​ff

Karen Moore - Clinical Nurse Specialist, Urology Cancer: 01782 679370

Mr Christopher Luscombe - Consultant Urological Surgeon: 01782 679407

Mr Golash - Consultant Urological Surgeon: 01782 679409

Mr Samson Liu - Consultant Urological Surgeon: 01782 679408

Mr Mark Saxby - Consultant Urological Surgeon: 01782 679406

Mr Lyndon Gommersall - Consultant Urological Surgeon: 01782 679410

County Hospital​​

The Urology Ward, Ward 6, is located on the First Floor. Ward 6 is a 19 bedded surgical ward including four Level 1 beds. (The ward is shared with colorectal patients)

Contact Information: 01785 230096

Visiting Times & Restrictions: 3pm-5pm and 6.30pm-8pm

We are one of the largest urology units in the area offering all forms of contemporary urological techniques (including keyhole and laser techniques). The Trust is a designated cancer centre for urology, and are therefore able to take referrals from other hospitals. We provide a full range of care, offering both minor procedures and major procedures. University Hospitals is a respected laparoscopic centre, meaning we specialise in performing laparoscopic (keyhole) procedures wherever possible. For patients there are a number of benefits to having laparoscopic surgery, for example quicker recovery times, less chance of infection and less scarring.

This includes:​

• The first hospital in the world to report keyhole kidney removal surgery as a daycase and our surgeons help to teach other local hospitals to perform this procedure.
• The first local hospital to perform keyhole prostate removal and our surgeons help to teach other local hospitals to perform this procedure.
• The first local hospital to perform keyhole bladder removal (there are still few other organisations providing this service).

​University Hospitals was the first local hospital to perform keyhole removal of part of the kidney (partial nephrectomy). Our surgeons receive patients referred from the region for this procedure and help to teach consultants from other hospitals to perform this procedure. We also provide laser surgery for kidney stones and prostate enlargement. This includes using the latest generation of Greenlight Laser to perform PVP (Photoselective Vaporization of the Prostate) to treat men with lower urinary tract symptoms requiring surgery, which is a modern alternative to conventional prostate surgery, or TURP (Trans Urethral Resection of the Prostate).​

This leaflet has been written to help you understand your diagnosis. If you have any questions or concerns, please do not hesitate to contact your specialist nurse.

What is advanced prostate cancer?

This is a term used to describe a prostate cancer that has spread outside of the prostate gland to nearby organs and structures and may also have spread to distant sites such as the bones (metastases). This leaflet has been written to help you understand more about the treatment options available to you.

What symptoms might I expect?

The symptoms experienced by men with advanced prostate cancer are usually linked to the effect on the prostate gland or the area of spread.

These symptoms might include:

• Waterworks problems
• Blood in the urine (haematuria)
• Pain in the bones

Some men may not experience any of these symptoms.

How will my prostate cancer be treated?

The aim of your treatment will be to control the cancer rather than cure it. Hormone Manipulation Therapy will be the key treatment. Prostate cancer needs testosterone to grow and Hormone Manipulation Therapy stops the
production of this hormone. By stopping testosterone from reaching your tumour, your cancer can be treated effectively. This treatment is effective for varying lengths of time and differs with individuals.

How is hormone manipulation treatment given?

These are the treatment options open to you; Hormone injections, which reduce the testosterone level in your body. Surgical removal of the part of the testicles, which produces testosterone called a bilateral orchidectomy. Both options are equally effective. You should read this leaflet alongside the leaflet entitled ‘Patient information for bilateral orchidectomy for prostate cancer’ before you make your decision.

Are there any alternatives to having hormone therapy and what would happen if I decided not to have this treatment?

Your consultant will have explained the different treatment options available to you and what would happen if you decided not to have any treatment at all. The choice about which treatment is best for you will be made together with your doctor or nurse. This will be based on the risks and benefits of the treatments and your individual circumstances. Without treatment your cancer may progress and it may be difficult to control any symptoms you have.

Are there any risks or long term effects involved in having hormone therapy?

Yes, there are side effects to nearly all treatments. Therefore you must consider the following side effects before deciding to undergo this treatment.

• Hot flushes and night sweats – these are common and may be severe in the first six to 12 months.
• You may also notice that you have to shave less often.
• Tiredness
• Weight gain
• A reduced sex drive
• Impotence – you will probably experience impotence once you start treatment. This is the inability to achieve an erection.
• Thinning of the bones - osteoporosis
• Breast swelling and tenderness

Less common side effects are:

• Joint pain
• Changes in blood pressure
• Skin rashes
• Low mood

There may be some treatment that can be given to you if any of these side effects are particularly troublesome. Speak to your GP, consultant or specialist nurse if you suffer from any of them.

How will my prostate cancer be monitored?

Hormone therapy works for a varying period of time and your PSA level informs the doctor or nurse of its effectiveness. It is anticipated that the treatment will become less effective in time which will require additional treatments. Your PSA level and symptoms will determine at what point new treatments will be introduced.

When am I likely to receive what treatment?

Hormone therapy is most often started when your diagnosis is made. This is called ‘first line hormone therapy’ meaning the first hormone treatment for you. There are several treatment options which can follow this first line therapy and as each treatment becomes less effective a new treatment option will be considered.

Diagnosis and treatment pathways

What further symptoms might I experience?

Pain is a symptom that worries people most with cancer. Prostate cancer which has spread into the bones can cause pain. This can be successfully
controlled with either the correct pain killers or with a dose of radiotherapy (X-ray treatment to the affected bone). Other symptoms you might experience include bleeding or increased difficulty in passing urine and osteoporosis (thinning of the bones). Please inform your GP, consultant or specialist nurse if you suffer any of these symptoms.

One rare complication of advanced prostate cancer is from the cancer affecting the bones in your spine. This can damage the nerves which can cause symptoms of numbness or tingling to your feet. This is called ‘spinal cord compression’ and requires urgent attention and treatment. If you experience this symptom please contact you GP immediately. Management of potential symptoms can be introduced when ever necessary throughout your treatment.

Pain > Analgesics

Bone complications > Local radiotherapy 

Water work problems > Medicines or surgery

Bone Thinning > Bisphosphonate medication

Spine complications > Steroids and/or Radiotherapy

Am I suitable for a trial?

There may be an opportunity to participate in a clinical trial. If a suitable trial is available to you this would usually be discussed with you, however please ask your consultant or nurse specialist if you would wish to be considered.

Where can I get further information and support?

Many people living with cancer may worry about what the future  holds. Concerns about tests and treatments are common. Some people find the
information given to them following a complicated clinic visit daunting and difficult to remember. Karen Smith is a Clinical Nurse Specialist in Urology who is available for you to call with any worries, questions or problems. Please telephone Karen on 01782 553820. (Answer machine available)

It may be helpful if you make a list of your concerns to help you remember to ask your consultant or specialist nurse the questions that are important to you.

Who else will be involved and able to help me?

Various people may become involved in your care. District nurses who work closely with your GP may visit you at home. Palliative care nurses
often become involved in patients care that have cancer. Palliative care nurses specialise in helping people with symptoms caused by their cancer. It is recommended these nurses get to know you early in your treatment and not when symptoms have become unbearable. Your consultant, specialist nurse or GP can ask the palliative care nurses to meet with you.

Useful Contacts

Karen Moore, Clinical Nurse Specialist
Urological Cancer. Tel; 01782 553820
(Answer machine available)

There is also a North Staffordshire Prostate Cancer Support Group, which is open to anyone affected by prostate cancer. If you wish to speak to someone receiving the same treatment this can be arranged for you either through the support group or your Nurse Specialist.

The North Staffs Prostate Cancer Support Group Held on the 3rd Wednesday of every month 6pm till 8pm
Joiners Square Community Centre
Corns Street
Hanley

Macmillan Cancer Support and Information Centre
University Hospital of North Midlands
Open for drop in sessions:
Monday – Thursday 10am until 12.30pm and 2pm until 4pm
Tel: 01782 554363. (Answer phone available out of hours)

National sources of further information

Macmillan cancer line 08088082020
Website: www.Macmillan.org.uk

BACUP (cancer information service)
Free phone 0800181199
Website: www.cancerbacup.org.uk

Cancer Help UK
Website: www.cancerhelp.org.uk

The Prostate Cancer Charity
Tel. 0845 300 8383
Email: info@prostate-cancer.org.uk
Website: www.prostate-cancer.org.uk

Prostate Cancer Support Association
Tel. 0845 6010766

Institute of Cancer Research
Tel. 020 7352 8133
Website: www.icr.ac.uk

Cancer Backup Information Service
Freephone 0808 800 1234

The Sexual Dysfunction Association
Tel. 0870 7743571
Website: www.impotence.org.uk

Cancer Help UK
Freephone 0800 226 237
Website: www.cancerhelp.org.uk

Who is this information for?

The tests that you have recently undergone show that your prostate cancer has spread outside of the prostate gland. This leaflet has been written to help you understand more about the treatment options
open to you.

The choice about which treatment is best for you will be made together with your doctor. This will be based on the risks and benefits of the treatments and your individual circumstances.

What are my options of treatment?

Prostate cancer needs testosterone to grow. By stopping testosterone from reaching your tumour, your cancer can be controlled effectively. This can
be done by an operation or by treatment with medicines; tablets or injections and is called ‘hormone manipulation therapy’ Your consultant will have explained the different treatment options available to you and what would happen if you decided not to have any treatment at all.

The treatment options open to you include;

• Surgical removal of the part of the testicles which produces testosterone called a bilateral or subcapsular orchidectomy.
• Tablets or injections of a hormone drug which reduces the testosterone level in your body.

Both options are equally effective. Information about hormone injections are contained in a separate leaflet which we would recommend that you also read entitled ‘Information for patients receiving hormone injection therapy for prostate cancer’ before you make your decision.

What is a bilateral or subcapsular orchidectomy?

An orchidectomy is a simple operation. A small cut is made in the scrotum (the sac that holds the testicles), and the part of both testicles that produce the male hormone testosterone is removed. It can be performed under a local or general anaesthetic. You will probably have to stay in hospital overnight but you might be able to go home the same day.

What are the benefits of having a bilateral orchidectomy?

When the cancer has spread beyond the prostate to nearby glands or bones (metastasised), the most effective form of treatment is ‘hormone manipulation therapy’. Having a bilateral orchidectomy is one way of achieving this permanently.

Are there any risks or long term effects involved in having the operation?

Yes, there are side effects to nearly all treatments. An orchidectomy cannot be reversed once it has been carried out. Therefore you must consider the following permanent side effects before consenting
to this operation.

Hot flushes and night sweats

Is possibly the most common side effect and can occur quite soon after this operation and can be severe particularly for the first six months. There are some medicines and alternative practices which may reduce these effects if they become problematic.

Sexual side effects and Infertility

Most methods of hormone therapies both surgical and with medicines can cause reduced or loss of libido (sexual desire), erection difficulties and make you infertile. If you have any concerns about any of these symptoms please discuss this with your consultant or nurse specialist. Treatments and sperm banking can be available.

Weight gain and Tiredness

Reducing your testosterone levels can result in you putting on weight and feeling tired both physically and mentally. If this becomes a problem to you please discuss it with your doctor or specialist nurse.

What can I expect before the operation?

Your operation will be explained to you and you will be encouraged to ask any questions you may have. You will have some tests carried out to check that you are fit enough for surgery and be asked to give your written consent for your operation.

What will happen after the operation?

You may feel some general discomfort and bruising to your scrotum in the week following surgery. We would encourage you to take the pain killer tablets that the hospital will send you home with. A scrotal support will be provided and we would recommend you wear this until the swelling has settled. Once the swelling from the operation has subsided, your scrotum will look different and will be reduced in size. Your stitches will dissolve but this may take several weeks, your wound will rarely need a dressing. Please contact your GP if you notice any increased swelling, pain or leakage of fluid from your wound site; This may mean that you have a
wound infection that needs treating with antibiotics.

What can I do to help?

We recommend that you;

• Avoid heavy lifting for two weeks following the operation.
• Avoid driving for two weeks and check with your insurer’s that you are covered to drive.
• Keep the wound clean by showering or bathing daily.

Who can I talk to and get further help?

Many people living with cancer may worry about what the future holds. Concerns about tests and treatments are common. It may help if you make a list of your concerns so that you can ask your consultant. If you have any questions or concerns about the treatment, please speak to your doctor, or contact the Clinical Nurse Specialist on telephone number 01782 553820. There is a 24 hour answer phone if you ring outside normal working hours

There is also a North Staffs Prostate Cancer Support Group which is open to anyone affected by prostate cancer. If you wish to speak to anyone receiving the same treatment this can be arranged for you either through the support group or your Clinical Nurse Specialist.

Further Information

Macmillan cancer support and Information Centre
University Hospital of North Midlands
Open for drop in sessions: Monday – Thursday 10am until 12.30pm and 2pm until 4pm. Friday by appointment only.
Or telephone on 01782 554363 any time.
(Answer phone available out of hours)

Useful Contacts

The Prostate Cancer Charity
Tel: 020 8222 7622 / 0845 300 8383
Email: info@prostate-cancer.org.uk
Prostate Cancer Support Association
Tel: 0845 6010766

Cancer Research UK
Tel: 020 7061 8355 / 0800 226 237
Email: cancer.info@cancer.org.uk

Bacup Cancer Information Service
Tel: 020 7739 2280 / 0808 800 1234
Email: info@cancerbacup.org

Cancer Link Helpline
Tel: 0808 800 0000
The Impotence Association Helpline
Tel: 020 8767 7791